Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
Expert Rev Clin Immunol. 2012 Jan;8(1):43-52; quiz 53-4. doi: 10.1586/eci.11.75.
Monoclonal antibodies are important therapeutic tools, but their usefulness is limited in patients who experience acute infusion reactions, most of which are consistent with type I hypersensitivity reactions including anaphylaxis. Patients who experience acute infusion reactions face the prospect of stopping treatment or switching to an alternative, and potentially more toxic or inferior treatment. Another option that overcomes the treatment hurdle of these reactions is rapid desensitization, a procedure in which the offending agent is re-administered in a step-wise, highly controlled fashion. While the risk of reactions is not completely eliminated, desensitization has proven to be a highly effective re-administration strategy for most patients who otherwise would not be able to tolerate their monoclonal antibody therapy owing to drug-induced anaphylaxis. This article reviews the current literature on desensitization and other readministration protocols to monoclonal antibodies with an emphasis on four agents: rituximab, infliximab, cetuximab and trastuzumab.
单克隆抗体是重要的治疗工具，但在经历急性输注反应的患者中，其用途有限，其中大多数与 I 型超敏反应一致，包括过敏反应。经历急性输注反应的患者面临停止治疗或改用替代药物的前景，而替代药物可能毒性更大或效果更差。另一种克服这些反应治疗障碍的方法是快速脱敏，这是一种逐步、高度控制地重新给予致病药物的程序。虽然反应的风险并未完全消除，但脱敏已被证明是一种非常有效的再给药策略，适用于大多数否则由于药物引起的过敏反应而无法耐受单克隆抗体治疗的患者。本文综述了关于脱敏和其他再给药方案的最新文献，重点介绍了四种药物：利妥昔单抗、英夫利昔单抗、西妥昔单抗和曲妥珠单抗。
